PAGD Keystone Explorer Fall 2019

Keystone Explorer |  Fall 2019  9 MODERATE SEDATION Relaxing the patient more deeply requires moderate sedation. The dentist must hold a Class I permit, which generally requires a 3-day course, ACLS card, and site visit. OPERATING ROOM: A PATH THAT ALWAYS WORKS When all else fails, I work on the ideal patient: one who is asleep and cannot spit, bite, kick, hit, or resist treatment in any way. Once a patient is under general anesthesia, it is virtually guaranteed that you will complete the case. Success depends only on your clinical dental skills and not the patient’s uncooperative behavior. This allows you to do your finest dentistry. We have calculated, based upon our last 2,000 OR cases, the hourly net income in the OR is more than four times that of our office cases. All our general anesthesia OR work is done with no interruptions by the patient. This applies to both hospitals and surgical centers. Advantages to having work done in the OR include: 1) This may be the patient’s last resort; 2) the patient has no unpleasant memory of being restrained or operated on; 3) the work gets done four times faster than it would in an office; and 4) dentists and hygienists do their best work when patients are not moving at all. To treat patients in an OR, you do not need a special permit. You only need what you already have: a license, liability insurance, and basic CPR card. CONCLUSION With no known exception, every patient can be treated successfully in a dental office or in an operating room. Determining the best path for each patient requires resourceful creativity that results from knowledge, skill, and practice. If you have the motivation, you can learn the clinical skills in CE courses and/or mentorships. There is always a primary or secondary road that will enable you to treat any patient, in the appropriate setting, either awake or asleep. Dr. Harvey Levy practices in Frederick, MD. He holds nine fellowships, five diplomate certificates, Mastership in the AGD, and five AGD LLSR awards. He is the recipient of the inaugural Maryland State Dental Association Humanitarian Award, the ADA Access to Care Award, the AGD Humanitarian Award, Tufts University Distinguished Alumni Award, MD Governor Dr. of the Year Award, and Special Care Dentistry’s Saul Kamen Award. Dr. Levy is on Dean’s faculty at University of Maryland and a 3-time Martial Arts Black Belt Hall-of-Famer. For copies or comments, please contact Dr. Harvey Levy at drhlevy@gmail.com or visit drhlevyassoc.com . Originally printed in the February 2015 Texas Dental Journal, updated and reprinted with permission. A dentist’s ideal clinical setting Quality and efficient dental care can be performed in the OR on patients who would not allow any treatment in an office setting dentistry issues Q Chair overlays convert adult into pedo chairs instantly